• 한국학교ㆍ지역보건교육학회지
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• 제15권3호
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• pp.81-93
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• 2014

Objectives: This study aims to find status of the oral health care, the oral health education program utilization and the oral health guidance according to the experience status of oral health education of special school teachers. Methods: The study subjects were 133 teachers at special schools in Seoul, Gyeonggi, Chungbuk and Jeonbuk regions. Results: 32.8% of the male and 67.2% of the female teachers have the oral health education experience. Barriers for the dental treatment to teachers with the education experience show in the order as 'disabled children's noncooperation' 49.2%, 'economic reasons' 37.7% and 'medical institution's rejection' 6.6% and, to teachers without the education experience, 'disabled children's noncooperation' 45.8%, 'economic reasons' 19.4% and 'not emergency situation' 13.9%(p<0.01). Regarding the necessity of arranged institution to manage the oral health, 91.8% of teachers with the oral health education answer as 'necessary'(p<0.05). Regarding the barriers on the performance of oral health program 27.9%, the majority of teachers with the education experience answer as 'insufficient administrative & financial support' and 36.1%, the majority of teachers without the education experience answer as 'insufficient understanding and expertise on the oral health education'. 86.9% of the teachers with the education experience and 62.5% of the teachers without the education experience are found to 'guide students on the oral health'(p<0.01). Conclusions: It was considered that various oral health education programs positively influential to the oral health care and education for disabled children should be developed according to the status of oral health education experience of special school teachers.

• 한국측량학회지
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• 제38권6호
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• pp.599-610
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• 2020

자동심장충격기(AED: Automated External Defibrillator)는 건물 또는 특정 영역 내에 위치함에도 공간적 정확성 및 시간적 가용성에 대한 평가가 이뤄지지 않음으로 이에 대한 공간분석 입지 할당 분석을 통한 구획이 필요하다. 분석결과 기설치 AED 및 공공데이터를 활용한 공간분석을 실시하고 GIS 입지분석 방법을 적용, 지역 주거특성에 맞는 365일 24시간 운용이 가능한 공공기관(119안전센터, 파출소(지서))을 공공 AED 거점후보지로 선정하고 후보지별 티센폴리곤을 생성, 권역별 구획을 실시하였다. AED 특성을 고려한 응급의료서비스 접근성 측면의 서비스권역 분석에서 연구지역 주요지역 대부분 응급의료 필요시간 4분내에 긴급차량이 도착할 수 있는 것으로 분석되었으나 도심 외곽지는 이에 못 미치는 양상이 나타났다. 결과적으로, 야간, 주말시간대의 AED 환자 대응을 위해 공공기관 차량 중심의 AED 거점 서비스센터 운영이 효과적임을 알 수 있었고 공공기관 AED 서비스센터 구축을 위한 대구시 관할 119안전센터, 지구대(파출소)에 대한 위치기반 거리, 속성 분석, 중복 지역 최소화 등으로 기존 도보 방식의 AED 이용보다 차량을 이용하는 방법이 더 효율적으로 나타났다.

• 미래기술융합논문지
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• 제2권2호
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• pp.15-21
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• 2023

본 연구는 손상 경험(사고 및 중독)이 의료 이용 형태에 미치는 영향을 알아보고자 하기 위함이다. 본 연구는 KNHANES VIII-2의 원시자료활 활용하였다. 총 대상자수는 7,359명 중 결측값, 20세 이하 연령층, 부적절한 표기 대상자 1,287명을 제외한 6,072명으로 하였다. 6,072명중 1년간 손상경험 응답자 5,355명을 대상으로 적용하였다. 본 연구의 분석방법은 SPSS WIN 20.0 Version 프로그램으로 분석하였다. 연구결과 젊은 연령층이 손상에 영향을 미쳤고(p<.05), 주관적 건강상태는 좋은 집단 보다 나쁨 집단(약 2.0배, p<.05)이 손상에 유의한 영향을 미치고 있었다. 손상횟수는 손상치료기관으로 외래와 입원보다 응급실 이용이 약 4-5배 이상 이용하는 것으로 나타났다(p<.05). 손상은 활동제한 및 일상생활을 어렵게 하고, 더불어, 의료이용 형태에서도 쏠림현상이 있을 수 있기에 이를 위한 프로그램 강화와 정책마련이 이루어 져야 할 것으로 판단된다.

• 대한산업공학회지
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• 제38권3호
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• pp.227-236
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• 2012

New 5-digit zone code (new postcode) will replace the current 6-digit postcode which has been used for postal automation in 2014. New postcode will be used for processing various works to distinguish location and area in the entire country. For example, it new postcode will be used to denote different administration areas, firefighting and police jurisdiction, weather forecast areas, emergency medical facility areas, social welfare institution areas, election districts, school districts, statistical areas, courier and delivery business areas, and etc. Therefore, the relevant authorities must be cosider for the feasibility and applicability of assigning the new postcode. In postal service, postal process will be affected a lot by new postcode because a postcode has been related with delivery area of a postman. Therefore, we propose assignment scheme for new postcode which will impact less to postal process. Then, we present how we used geographic data for efficient assignment and analysis of the results.

• Perspectives in Nursing Science
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• 제10권2호
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• pp.158-166
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• 2013

Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

• 한국융합학회논문지
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• 제12권4호
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• pp.285-291
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• 2021

본 연구는 외상성 경막하 혈종 환자의 생존 여부에 영향을 미치는 요인을 규명하기 위해 시도된 후향적 조사연구이다. 연구대상자는 G광역시에 소재한 C대학교 병원에 2017년 1월부터 2019년 2월까지 응급실로 내원한 외상성 경막하 혈종 환자 207명이다. 자료분석은 SPSS 23.0 프로그램을 이용하였으며, χ2-test, t-test, 로지스틱 회귀분석을 시행하였다. 연구결과 대상자의 생존 여부에 영향을 미치는 요인은 기저질환, 입원 시 합병증, 내원 시 GCS로 나타났다. 따라서 대상자의 과거력을 확인할 수 있는 의료시스템 구축과 합병증 예방을 위한 의료진의 교육이 이루어져야 할 것이다. 이와 함께 의료기관 이송 전 단계부터 대상자의 GCS를 측정하여 신속히 치료 가능한 병원으로 이송될 수 있도록 이송체계의 개선이 필요하다.

• 한국방사선학회논문지
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• 제14권4호
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• pp.467-475
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• 2020

본 연구는 PET 검사 중 방사성의약품인 ¹⁸F-FDG에 대한 선량을 평가하여 환자와 보호자의 방사선에 대한 불안감을 완화하고, 의료기관 인력 및 공간 확보 문제, 건강검진으로 인한 무분별한 검사 진행을 최소화하는 데 그 목적이 있다. 선량평가는 방사선조직가중치 중 높은 조직 세 부위인 경부(갑상선), 흉부(심장), 하복부(생식선) 위치에 열형광선량계(TLD)와 전자개인선량계(EPD)를 이용하여 측정하였다. 또한, GM 계수기와 전리함을 이용하여 공간선량률과 소변에서의 방사능을 측정하였다. 그 결과는 다음과 같다. 첫째, 개인선량계인 TLD는 경부에서 0.0425±0.0277 mSv, 흉부에서 0.0485±0.0386 mSv, 하복부에서 0.0485±0.0436 mSv 측정되었고 방사선 민감도에 따른 심부선량 차이는 거의 없었다. EPD는 경부 위치에서 직후 0.942±0.141 mSv/h, 120분 후 0.192±0.031 mSv/h로 측정되었다. 흉부 위치에서 직후 0.516±0.085 mSv/h, 120분 후 0.128±0.040 mSv/h로 측정되었다. 하복부 위치에서 직후 0.468±0.091 mSv/h, 120분 후 0.105±0.021 mSv/h로 측정되었다. GM 계수기에서 공간선량률은 직후 0.041±0.005 mSv/h, 120분 후 0.014±0.002 mSv/h로 측정되었다. 전리함을 이용한 소변 내 방사능은 60분 후 0.113±0.24 MBq/cc, 120분 후 0.063±0.13 MBq/cc로 측정되었다. 이러한 결과로 볼 때 ¹⁸F-FDG를 투여하고 PET 검사가 끝나는 2시간 후 선량 재평가를 하고 귀가 시점을 정하도록 해야 하며 보호자와의 접촉도 피해야 한다. 또한, 환자와 보호자에게 충분한 설명과 함께 피폭선량 예상 값을 제공하여 무분별한 검사를 지양해야 하도록 할 필요가 있을 것으로 판단된다. 본 연구에서 실측 실험한 데이터를 통해 환자와 가족들이 방사선에 대한 불안감을 해소하기를 바라며, 방사선 종사자의 피폭관리 시스템과 제도적 개선을 통해 의료방사선 발전에 힘이 되리라 기대한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권6호
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• pp.293-298
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• 2015

Objectives: Infection involving the orbit, zygomatic space, lateral pharyngeal space, or hemifacial and oral floor phlegmon is referred to as cervicofacial infection (CFI). When diagnosis and/or adequate treatment are delayed, these infections can be life-threatening. Most cases are the result of odontogenic infections. We highlight our experiences in the management of this life-threatening condition. Materials and Methods: This was a retrospective study of patients who presented with CFI from December 2005 to June 2012 at the Oral and Maxillofacial Surgery Clinic or the Accident and Emergency Unit of Ahmadu Bello University Teaching Hospital (Zaria, Nigeria). The medical records of all patients who presented with either localized or diffuse infection of the maxillofacial soft tissue spaces were retrospectively collected. Data collected was analyzed using SPSS version 13.0 and are expressed as descriptive and inferential statistics. Results: Of the 77 patients, 49 patients (63.6%) were males, a male to female ratio of 1:7.5. The ages ranged from two years to 75 years with a mean of $35.0{\pm}19.3$ years, although most patients were older than 40 years. The duration of symptoms prior to presentation ranged from 6 to 60 days, with a mean of $11.0{\pm}9.4$ days. More than 90% of the patients presented to the clinic within the first 10 days. The most commonly involved anatomical space was the submandibular space (n=29, 37.7%), followed by hemifacial space (n=22, 28.6%) and buccal space (n=7, 9.1%). Ludwig angina accounted for about 7.8% of the cases. Conclusion: CFI most commonly involves the submandibular space, typically affects individuals with a low level of education, and is influenced by traditional medical practices. Despite improved health care delivery, CFI remains a significant problem in developing countries.

• Journal of Chest Surgery
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• 제44권5호
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• pp.343-347
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• 2011

Background: Acute pulmonary thromboembolism is fatal because of abruptly occurring hypoxemia and right ventricular failure. There are several treatment modalities, including anticoagulation, thrombolytics, ECMO (extracorporeal membrane oxygenator), and thromboembolectomy, for managing acute pulmonary thromboembolism. Materials and Methods: Medical records from January 1999 to December 2004 at our institution were retrospectively reviewed for pulmonary thromboembolectomy. There were 7 patients (4 men and 3 women), who underwent a total of 8 operations because one patient had post-operative recurrent emboli and underwent reoperation. Surgery was indicated for mild hypoxemia and performed with CPB (cardiopulmonary bypass) in a beating heart state. Results: The patients had several symptoms, such as dyspnea, chest discomfort, and palpitation. Four patients had deep vein thromboembolisms and 3 had psychotic problems, specifically schizophrenia. Post-operative complications included hemothorax, pleural effusion, and pericardial effusion. There were two hospital deaths, one each by brain death and right heart failure. Conclusion: Emergency operation should be performed when medical treatments are no longer effective.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.148-153
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• 2015

Purpose: We investigated trends in antibiotic resistance for gram-negative bacteria in infants with a urinary tract infection (UTI) over 15 years at a single institution. Methods: A retrospective chart review was conducted for children younger than 24 months who visited the emergency room and were diagnosed with a UTI between January 2000 and December 2014. We selected urine culture data that grew Escherichia coli and Klebsiella pneumoniae. Baseline clinical information and results of antimicrobial susceptibility tests were analyzed by dividing the 15-year study time frame into three periods (A: 2000-2004, B: 2005-2009, and C: 2010-2014). Results: During the study period, 478 applicable children were identified (E. coli, 89.7% and K. pneumoniae, 10.3%). Antibiotic resistance to third-generation cephalosporins was increased from period A to period C (A, 2.1%; B, 8.3%; C, 8.8%; P=0.025). Resistance to quinolones also showed a steady pattern during periods A to C, although it was not statistically significant (A, 7.9%; B, 9.7%; C, 12.4%; P=0.221). The incidence of Extended-spectrum ${\beta}$-lactamase (ESBL)-producing gram-negative bacteria increased from period A to period C (A, 1.4%; B, 7.6%; C, 8.2%; P=0.012). Conclusion: This study revealed that the common uropathogens E. coli and K. pneumoniae experienced increasing resistance rates against third-generation cephalosporins and a constant antibiotic resistance to quinolones in children younger than 24 months. We also showed a recent increased incidence of ESBL-producing gram-negative bacteria in patients with community-acquired UTIs. Therefore, it is necessary to actively surveil resistance in order to properly select empirical antibiotics.